Yoto Yotov | Medical University of Varna (original) (raw)
Papers by Yoto Yotov
![Research paper thumbnail of [PP.14.19] Galectin 3 in Elderly Patients with Atrial Fibrillation and Restored Sinus Rhythm](https://attachments.academia-assets.com/117258572/thumbnails/1.jpg)
](Journal of Hypertension, 2016
Eastern journal of medical sciences, Jul 18, 2022
Background: Cardiovascular diseases (CVDs) are the major cause of death globally. Among them, hea... more Background: Cardiovascular diseases (CVDs) are the major cause of death globally. Among them, heart failure (HF) and atrial fibrillation (AF) result in poor prognosis and quality of life. Standard methods for assessing AF and HF, through history and physical examination, have limited sensitivity and specificity, which lead to delayed diagnosis and high risk of mortality. The identification of biomarkers able to detect the early stages of disease and/or their progression is of great importance for improving the clinical outcome. As AF and HF often coexist, it would be of great importance to find a biomarker with diagnostic utility in predicting HF in AF patients. Soluble suppression of tumorigenesis-2 (sST2) is a part of the cardioprotective IL-33/ST2 signaling pathway and may serve as a candidate biomarker for HF and AF. We aimed to evaluate sST2 serum levels in patients with AF and HF with preserved ejection fraction (HFpEF) and to explore potential relationships with traditional CVD risk factors and with novel biomarkers for vascular calcification such as undercarboxylated matrix Gla-protein (ucMGP). Materials and Methods: This study included 99 patients stratified into three groups: HFpEF (n=19), paroxysmal or persistent AF in sinus rhythm (n=33), and control group without CVD but at moderate-to-high CVD risk (n=47). Hemodynamic and anthropometric measures, coronary artery calcification (CAC), routine laboratory parameters, circulating ucMGP, and sST2 were measured. Results: sST2 levels were highly elevated in HFpEF patients. Significant positive correlation was found between sST2 and CAC-score (r=0.237, p=0.039), negative relations with serum lipids in AF patients, and positive association with serum C-reactive protein (r=0.609, p=0.018) in HFpEF patients. Soluble ST2 positively correlates with ucMGP in the entire studied population (r=0.252, p=0.006) and in the combined CVD group (AF+HFpEF) (r=0.254, p=0.036). Conclusions: sST2 levels emerge as a novel biomarker in CVD and may have prognostic importance for HF prediction in AF patients.
Frontiers in Nutrition
IntroductionNutrition education attempts to maintain and enhance good eating habits to achieve op... more IntroductionNutrition education attempts to maintain and enhance good eating habits to achieve optimal metabolic control in people with type 1 diabetes (T1D). Recommendations for patients with T1D are comparable to those of the general population.This Study AimedTo investigate dietary habits and adherence to nutritional recommendations of patients with T1D as compared with age, gender, and BMI matched people in Bulgaria.MethodsA case-control study included 124 patients with T1D with long disease duration (mean duration 25.3 ± 8.2 years) followed up at a diabetes clinic in Varna, Bulgaria for 2 years (2017–2019) and 59 controls matched for gender, age and BMI. A 24-h dietary recall method was used to assess the nutrition of both groups. A standardized questionnaire was applied to assess the frequency of food consumption (Feel4Diabtes). Height and weight were standardly measured, and BMI was calculated. Findings were compared with Bulgarian recommendations and reference values for ene...
Clinical Research in Cardiology
In this article, the name of the GLORIA-AF investigator Anastasios Kollias was given incorrectly ... more In this article, the name of the GLORIA-AF investigator Anastasios Kollias was given incorrectly as Athanasios Kollias in the Acknowledgements. The original article has been corrected.
Journal of Hypertension, 2021
Romanian Medical Journal, 2015
Heart disease is one of the most important causes of morbidity and mortality in the population of... more Heart disease is one of the most important causes of morbidity and mortality in the population of Romania. In this context, the accessibility of patients to accurate and complete cardiology services, and its circuit in the Romanian health system, is one of the major priorities. A good knowledge of health systems focused primarily on addressing cardiac pathology at the level of two neighboring countries, members of the European Union can only lead to the identification of positive aspects under both systems, which can form the basis for efficient policies health in this area.
The Journal of Clinical Endocrinology & Metabolism, 2019
Context No universal waist circumference (WC) percentile cutoffs used have been proposed for scre... more Context No universal waist circumference (WC) percentile cutoffs used have been proposed for screening central obesity in children and adolescents. Objective To develop international WC percentile cutoffs for children and adolescents with normal weight based on data from 8 countries in different global regions and to examine the relation with cardiovascular risk. Design and Setting We used pooled data on WC in 113,453 children and adolescents (males 50.2%) aged 4 to 20 years from 8 countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cutoffs in samples including or excluding children with obesity, overweight, or underweight. WC percentiles were generated using the general additive model for location, scale, and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cutoffs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data fr...
![Research paper thumbnail of [PP.14.16] Galectin 3 Increases in Hypertensive Patients with Atrial Fibrillation and Restored Sinus Rhythm After One Year](https://attachments.academia-assets.com/93269749/thumbnails/1.jpg)
](Journal of Hypertension, 2016
Results: Abnormal LFTs occurred in 166(51.6%) of patients. Increase of ALT and/or AST were detect... more Results: Abnormal LFTs occurred in 166(51.6%) of patients. Increase of ALT and/or AST were detected in 68(21.1%) patients (alone ALT/alone AST/both TA-in 35.3/26.5/38.2% respectively), increase of AP and/or GGT in 140 (43.4%) patients (alone AP/alone GGT/both of them-in 27.15/35.7/37.15% respectively). Hepatocellular, cholestatic and mixed pattern of CHS was detected in 8.1, 30.4 and 13.1% of patients with ADHF. In patients with CHS the prevalence of hepatocellular, cholestatic and mixed pattern was 15.7,59,25.3% respectively. Patients with mixed CHS comparing with hepatocellular or cholestatic patterns had lower BMI(28.4 ± 5.3 vs 30.2 ± 7.6 or 31.4 ± 5.6 kg/m 2 ,p < 0.05), total protein (64 ± 4.8 vs 64.7 ± 6.7 or 68.9 ± 7.3 g/l,p < 0.01), eGFR(47 ± 17 vs 57 ± 17 or 56 ± 20 ml/min/1.73m 2 , p < 0.01), higher heart rate(118 ± 35 vs 91 ± 17 or 101 ± 30 per min, p < 0.01), Hb(137 ± 20 vs 120 ± 22 or 129 ± 24 g/l, p < 0.05), serum creatinine(146 ± 71 vs 117 ± 39 or 117 ± 34 mol/l, p < 0.001). Only mixed CHS was associated with negative prognosis. In patients with versus without mixed CHS the incidence of all-cause death in 6 months was 24.2 vs 12.1%, p < 0,05. Conclusions: Abnormal LFTs occurred in 51.6% of patients with ADHF.The prevalence of hepatocellular, cholestatic and mixed pattern was 15.7, 59, 25.3%. Patients with mixed compared with hepatocellular or cholestatic pattern of CHS had a worse prognosis.
Acute heart failure (AHF) is an integral part of the course of chronic disease, such as HF. It ca... more Acute heart failure (AHF) is an integral part of the course of chronic disease, such as HF. It can be initial de novo or acutely decompensated chronic HF, but this cardinal division is contested in the new published universal defi nition of HF. Basic and newer diagnostic methods are considered in this review to help the medical professionals in fi nding the exact reason for dyspnea and to defi ne patients at increased risk of adverse outcomes. The therapeutic possibilities for managing AHF in recent years with their successes and failures are discussed. It is concluded that AHF is a clinical syndrome with still high mortality and rehospitalization rates and that the timely diagnosis and treatment may favourably affect the prognosis.
INTRODUCTION Cardiac fibrosis is the hallmark of atrial remodeling in atrial fibrillation. Galect... more INTRODUCTION Cardiac fibrosis is the hallmark of atrial remodeling in atrial fibrillation. Galectin-3 (Gal-3) is a biomarker of fibrosis. It is well studied in heart failure, but the data about its role in atrial fibrillation are sparse. AIM The aim of the study was to evaluate the levels of Gal-3 in patients with atrial fibrillation after sinus rhythm restoration, to examine the association between this biomarker and other factors for developing atrial fibrillation and to assess its prognostic role. MATERIALS AND METHODS We included 67 patients (35 male) at the mean age of 67.36±7.25 years, with Gal-3 test after sinus rhythm restoration, a subgroup of participants in placebo-controlled randomized clinical trial of treatment with spironolactone. They were followed up for atrial fibrillation recurrence and hospitalizations. The effect of demographic parameters and other factors on Gal-3 levels were evaluated before and one year after treatment. RESULTS Mean Gal-3 at baseline was 16.9...
Journal of IMAB - Annual Proceeding (Scientific Papers), 2019
Bulgarian Cardiology, 2020
Transthyretin cardiac amyloidosis is a restrictive cardiomyopathy ((ATTR-CM), caused by an extrac... more Transthyretin cardiac amyloidosis is a restrictive cardiomyopathy ((ATTR-CM), caused by an extracellular deposition of insoluble amyloid fibrils in the myocardium. It is a life threatening disease with life expectancy of 2 to 6 years after diagnosis. There are two types – hereditary and wild type. Recent data reveal that the wild type ATTR-CM is a common cause of heart failure with preserved ejection fraction, especially in elderly men. Hereditary ATTR amyloidosis is not so rare in Bulgaria. Five different mutations have been diagnosed, the most common being p.Glu89Gln, identified in 62 unrelated families with 117 patients and 72 mutation carriers. ATTR-CM diagnosis is often delayed or even missed, however its early recognition has become very important as a new drug, which is a transthyretin stabilizer is now available and other drugs are under development. Updated knowledge about the clinical presentation, diagnostic algorithm, available and future therapeutic options for ATTR-CM ...
Известия на Съюза на учените – Варна Серия „Медицина и екология”
In recent years еpicardial adipose tissue has been reported to be an independent predictor of cor... more In recent years еpicardial adipose tissue has been reported to be an independent predictor of coronary risk, along with the already well established coronary calcium score. In our study we look for a corellation between these two markers in patients with long-term diabetes mellitus type 1 and healthy controls. Epicardial fat volume is quantified by semiautomatically and manually segmenting images acquired with computed tomography and magnetic resonance tomography. The two types of images demonstrate excellent correlation between them. A mild to moderate correlation between epicardial fat volume and coronary calcium score is found, regardless of which type of image the fat is calculated from.
Известия на Съюза на учените – Варна Серия „Медицина и екология”
Among the traditional risk factors for cardiovascular diseases (CVD) in individuals with type 1 d... more Among the traditional risk factors for cardiovascular diseases (CVD) in individuals with type 1 diabetes mellitus (T1DM), new ones are constantly being sought for timely prophylaxis and treatment. The increasing knowledge of the role of inflammation and visceral adipose tissue in the pathogenesis of T1DM complications is an integral part of the work of leading European centers. Obesity is a progressing risk factor and its role in the cardiovascular pathology of patients with T1DM is unclear. Lack of established practices and algorithms for management in these individuals has been poorly studied and presented to date. With prevalence of intensified insulin therapy in T1DM, leading sometimes to relatively high doses, and with the contemporary habits of eating, the patients’ risk of morbidity and mortality increases. Prioritization of cost-effective projects and specific timely commitment to protect disability in these patients is of utmost importance in scientific and healthcare aspects. The aim of this article is to present the design of the study of the cardiovascular and metabolic risk in patients with long-term T1DM.
Turkish Journal of Biochemistry
Objectives Matrix Gla protein (MGP) is a calcification inhibitor that plays a role in preventing ... more Objectives Matrix Gla protein (MGP) is a calcification inhibitor that plays a role in preventing soft tissue calcification and local mineralization of the vascular wall. The present study aimed to assess the expression of MGP in Peripheral Blood Mononuclear Cells (PBMC) in adult patients with CVD pathologies and its association with the presence and severity of coronary artery calcium score (CACS) and conventional CVD risk factors. Methods MGP expression was measured in 87 individuals using real time qPCR. Subgrouping was performed according etiologic and metabolic CVD risk factors. Results A clear trend for a decreased MGP expression was observed in all subgroups with high CVD risk. This decrease was significant in abdominally obese hypertensive individuals and in those with dyslipidemia. MGP expression was significantly lower in patients representing high Total cholesterol and LDL cholesterol levels. A positive correlation between MGP expression and smoking status in patients with...
Pharmacia
Objective: Atrial fibrillation is progressive disease with important health consequences, in whic... more Objective: Atrial fibrillation is progressive disease with important health consequences, in which fibrosis is a key player. The aim of our study is to assess the effect of mineralcorticoid blockade on top of standard treatment in patients with atrial fibrillation after sinus rhythm restoration on the recurrence of the arrhythmia, hospitalizations and on the changes in levels of Galectin-3 as a marker of fibrosis. Methods: We prospectively studied 101 consecutive patients (56 females) at mean age 68.2 ± 7 with atrial fibrillation and sinus rhythm restoration, who were randomized on treatment with spironolactone on top of standard treatment or “usual care”. They were followed up for recurrences, hospitalization and death. The effect of spironolactone on safety was evaluated. Results: Recurrences of AF were detected in 64% of non-spironolactone group vs 57% in spironolactone group (p = 0.44). Spironolactone reduced the hospitalizations for AF, but it was not significant (p = 0.14). A ...
Purpose: To assess the role of asymptomatic hyperuricemia for the presence and severity of corona... more Purpose: To assess the role of asymptomatic hyperuricemia for the presence and severity of coronary arterial calcium (CAC) in adults with different cardiovascular (CV) pathology and its association with conventional CV risk factors. Material/Methods: Adults (n=81) of both genders were divided into controls: with moderateto high risk without known CVD; AF-group: CVD-patients with paroxysmal or persistent atrial fibrillation in sinus rhythm, HF–group: heart failure subjects with preserved ejection fraction. A structured interview was performed at admittance for evaluation of the classical CVD risk factors. CAC score (CACS) was determined by multislice computed tomography. Routine laboratory parameters, including uric acid (UA), were extracted from medical documentation. Descriptive statistics, Mann-Whitney U-test, one-way ANOVA, chi-square test, Spearman’s correlation, and multiple linear regression analysis were applied. The predictive power of serum UA was evaluated using receiver o...
Journal of Hypertension, 2016
Eastern journal of medical sciences, Jul 18, 2022
Background: Cardiovascular diseases (CVDs) are the major cause of death globally. Among them, hea... more Background: Cardiovascular diseases (CVDs) are the major cause of death globally. Among them, heart failure (HF) and atrial fibrillation (AF) result in poor prognosis and quality of life. Standard methods for assessing AF and HF, through history and physical examination, have limited sensitivity and specificity, which lead to delayed diagnosis and high risk of mortality. The identification of biomarkers able to detect the early stages of disease and/or their progression is of great importance for improving the clinical outcome. As AF and HF often coexist, it would be of great importance to find a biomarker with diagnostic utility in predicting HF in AF patients. Soluble suppression of tumorigenesis-2 (sST2) is a part of the cardioprotective IL-33/ST2 signaling pathway and may serve as a candidate biomarker for HF and AF. We aimed to evaluate sST2 serum levels in patients with AF and HF with preserved ejection fraction (HFpEF) and to explore potential relationships with traditional CVD risk factors and with novel biomarkers for vascular calcification such as undercarboxylated matrix Gla-protein (ucMGP). Materials and Methods: This study included 99 patients stratified into three groups: HFpEF (n=19), paroxysmal or persistent AF in sinus rhythm (n=33), and control group without CVD but at moderate-to-high CVD risk (n=47). Hemodynamic and anthropometric measures, coronary artery calcification (CAC), routine laboratory parameters, circulating ucMGP, and sST2 were measured. Results: sST2 levels were highly elevated in HFpEF patients. Significant positive correlation was found between sST2 and CAC-score (r=0.237, p=0.039), negative relations with serum lipids in AF patients, and positive association with serum C-reactive protein (r=0.609, p=0.018) in HFpEF patients. Soluble ST2 positively correlates with ucMGP in the entire studied population (r=0.252, p=0.006) and in the combined CVD group (AF+HFpEF) (r=0.254, p=0.036). Conclusions: sST2 levels emerge as a novel biomarker in CVD and may have prognostic importance for HF prediction in AF patients.
Frontiers in Nutrition
IntroductionNutrition education attempts to maintain and enhance good eating habits to achieve op... more IntroductionNutrition education attempts to maintain and enhance good eating habits to achieve optimal metabolic control in people with type 1 diabetes (T1D). Recommendations for patients with T1D are comparable to those of the general population.This Study AimedTo investigate dietary habits and adherence to nutritional recommendations of patients with T1D as compared with age, gender, and BMI matched people in Bulgaria.MethodsA case-control study included 124 patients with T1D with long disease duration (mean duration 25.3 ± 8.2 years) followed up at a diabetes clinic in Varna, Bulgaria for 2 years (2017–2019) and 59 controls matched for gender, age and BMI. A 24-h dietary recall method was used to assess the nutrition of both groups. A standardized questionnaire was applied to assess the frequency of food consumption (Feel4Diabtes). Height and weight were standardly measured, and BMI was calculated. Findings were compared with Bulgarian recommendations and reference values for ene...
Clinical Research in Cardiology
In this article, the name of the GLORIA-AF investigator Anastasios Kollias was given incorrectly ... more In this article, the name of the GLORIA-AF investigator Anastasios Kollias was given incorrectly as Athanasios Kollias in the Acknowledgements. The original article has been corrected.
Journal of Hypertension, 2021
Romanian Medical Journal, 2015
Heart disease is one of the most important causes of morbidity and mortality in the population of... more Heart disease is one of the most important causes of morbidity and mortality in the population of Romania. In this context, the accessibility of patients to accurate and complete cardiology services, and its circuit in the Romanian health system, is one of the major priorities. A good knowledge of health systems focused primarily on addressing cardiac pathology at the level of two neighboring countries, members of the European Union can only lead to the identification of positive aspects under both systems, which can form the basis for efficient policies health in this area.
The Journal of Clinical Endocrinology & Metabolism, 2019
Context No universal waist circumference (WC) percentile cutoffs used have been proposed for scre... more Context No universal waist circumference (WC) percentile cutoffs used have been proposed for screening central obesity in children and adolescents. Objective To develop international WC percentile cutoffs for children and adolescents with normal weight based on data from 8 countries in different global regions and to examine the relation with cardiovascular risk. Design and Setting We used pooled data on WC in 113,453 children and adolescents (males 50.2%) aged 4 to 20 years from 8 countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cutoffs in samples including or excluding children with obesity, overweight, or underweight. WC percentiles were generated using the general additive model for location, scale, and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cutoffs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data fr...
Journal of Hypertension, 2016
Results: Abnormal LFTs occurred in 166(51.6%) of patients. Increase of ALT and/or AST were detect... more Results: Abnormal LFTs occurred in 166(51.6%) of patients. Increase of ALT and/or AST were detected in 68(21.1%) patients (alone ALT/alone AST/both TA-in 35.3/26.5/38.2% respectively), increase of AP and/or GGT in 140 (43.4%) patients (alone AP/alone GGT/both of them-in 27.15/35.7/37.15% respectively). Hepatocellular, cholestatic and mixed pattern of CHS was detected in 8.1, 30.4 and 13.1% of patients with ADHF. In patients with CHS the prevalence of hepatocellular, cholestatic and mixed pattern was 15.7,59,25.3% respectively. Patients with mixed CHS comparing with hepatocellular or cholestatic patterns had lower BMI(28.4 ± 5.3 vs 30.2 ± 7.6 or 31.4 ± 5.6 kg/m 2 ,p < 0.05), total protein (64 ± 4.8 vs 64.7 ± 6.7 or 68.9 ± 7.3 g/l,p < 0.01), eGFR(47 ± 17 vs 57 ± 17 or 56 ± 20 ml/min/1.73m 2 , p < 0.01), higher heart rate(118 ± 35 vs 91 ± 17 or 101 ± 30 per min, p < 0.01), Hb(137 ± 20 vs 120 ± 22 or 129 ± 24 g/l, p < 0.05), serum creatinine(146 ± 71 vs 117 ± 39 or 117 ± 34 mol/l, p < 0.001). Only mixed CHS was associated with negative prognosis. In patients with versus without mixed CHS the incidence of all-cause death in 6 months was 24.2 vs 12.1%, p < 0,05. Conclusions: Abnormal LFTs occurred in 51.6% of patients with ADHF.The prevalence of hepatocellular, cholestatic and mixed pattern was 15.7, 59, 25.3%. Patients with mixed compared with hepatocellular or cholestatic pattern of CHS had a worse prognosis.
Acute heart failure (AHF) is an integral part of the course of chronic disease, such as HF. It ca... more Acute heart failure (AHF) is an integral part of the course of chronic disease, such as HF. It can be initial de novo or acutely decompensated chronic HF, but this cardinal division is contested in the new published universal defi nition of HF. Basic and newer diagnostic methods are considered in this review to help the medical professionals in fi nding the exact reason for dyspnea and to defi ne patients at increased risk of adverse outcomes. The therapeutic possibilities for managing AHF in recent years with their successes and failures are discussed. It is concluded that AHF is a clinical syndrome with still high mortality and rehospitalization rates and that the timely diagnosis and treatment may favourably affect the prognosis.
INTRODUCTION Cardiac fibrosis is the hallmark of atrial remodeling in atrial fibrillation. Galect... more INTRODUCTION Cardiac fibrosis is the hallmark of atrial remodeling in atrial fibrillation. Galectin-3 (Gal-3) is a biomarker of fibrosis. It is well studied in heart failure, but the data about its role in atrial fibrillation are sparse. AIM The aim of the study was to evaluate the levels of Gal-3 in patients with atrial fibrillation after sinus rhythm restoration, to examine the association between this biomarker and other factors for developing atrial fibrillation and to assess its prognostic role. MATERIALS AND METHODS We included 67 patients (35 male) at the mean age of 67.36±7.25 years, with Gal-3 test after sinus rhythm restoration, a subgroup of participants in placebo-controlled randomized clinical trial of treatment with spironolactone. They were followed up for atrial fibrillation recurrence and hospitalizations. The effect of demographic parameters and other factors on Gal-3 levels were evaluated before and one year after treatment. RESULTS Mean Gal-3 at baseline was 16.9...
Journal of IMAB - Annual Proceeding (Scientific Papers), 2019
Bulgarian Cardiology, 2020
Transthyretin cardiac amyloidosis is a restrictive cardiomyopathy ((ATTR-CM), caused by an extrac... more Transthyretin cardiac amyloidosis is a restrictive cardiomyopathy ((ATTR-CM), caused by an extracellular deposition of insoluble amyloid fibrils in the myocardium. It is a life threatening disease with life expectancy of 2 to 6 years after diagnosis. There are two types – hereditary and wild type. Recent data reveal that the wild type ATTR-CM is a common cause of heart failure with preserved ejection fraction, especially in elderly men. Hereditary ATTR amyloidosis is not so rare in Bulgaria. Five different mutations have been diagnosed, the most common being p.Glu89Gln, identified in 62 unrelated families with 117 patients and 72 mutation carriers. ATTR-CM diagnosis is often delayed or even missed, however its early recognition has become very important as a new drug, which is a transthyretin stabilizer is now available and other drugs are under development. Updated knowledge about the clinical presentation, diagnostic algorithm, available and future therapeutic options for ATTR-CM ...
Известия на Съюза на учените – Варна Серия „Медицина и екология”
In recent years еpicardial adipose tissue has been reported to be an independent predictor of cor... more In recent years еpicardial adipose tissue has been reported to be an independent predictor of coronary risk, along with the already well established coronary calcium score. In our study we look for a corellation between these two markers in patients with long-term diabetes mellitus type 1 and healthy controls. Epicardial fat volume is quantified by semiautomatically and manually segmenting images acquired with computed tomography and magnetic resonance tomography. The two types of images demonstrate excellent correlation between them. A mild to moderate correlation between epicardial fat volume and coronary calcium score is found, regardless of which type of image the fat is calculated from.
Известия на Съюза на учените – Варна Серия „Медицина и екология”
Among the traditional risk factors for cardiovascular diseases (CVD) in individuals with type 1 d... more Among the traditional risk factors for cardiovascular diseases (CVD) in individuals with type 1 diabetes mellitus (T1DM), new ones are constantly being sought for timely prophylaxis and treatment. The increasing knowledge of the role of inflammation and visceral adipose tissue in the pathogenesis of T1DM complications is an integral part of the work of leading European centers. Obesity is a progressing risk factor and its role in the cardiovascular pathology of patients with T1DM is unclear. Lack of established practices and algorithms for management in these individuals has been poorly studied and presented to date. With prevalence of intensified insulin therapy in T1DM, leading sometimes to relatively high doses, and with the contemporary habits of eating, the patients’ risk of morbidity and mortality increases. Prioritization of cost-effective projects and specific timely commitment to protect disability in these patients is of utmost importance in scientific and healthcare aspects. The aim of this article is to present the design of the study of the cardiovascular and metabolic risk in patients with long-term T1DM.
Turkish Journal of Biochemistry
Objectives Matrix Gla protein (MGP) is a calcification inhibitor that plays a role in preventing ... more Objectives Matrix Gla protein (MGP) is a calcification inhibitor that plays a role in preventing soft tissue calcification and local mineralization of the vascular wall. The present study aimed to assess the expression of MGP in Peripheral Blood Mononuclear Cells (PBMC) in adult patients with CVD pathologies and its association with the presence and severity of coronary artery calcium score (CACS) and conventional CVD risk factors. Methods MGP expression was measured in 87 individuals using real time qPCR. Subgrouping was performed according etiologic and metabolic CVD risk factors. Results A clear trend for a decreased MGP expression was observed in all subgroups with high CVD risk. This decrease was significant in abdominally obese hypertensive individuals and in those with dyslipidemia. MGP expression was significantly lower in patients representing high Total cholesterol and LDL cholesterol levels. A positive correlation between MGP expression and smoking status in patients with...
Pharmacia
Objective: Atrial fibrillation is progressive disease with important health consequences, in whic... more Objective: Atrial fibrillation is progressive disease with important health consequences, in which fibrosis is a key player. The aim of our study is to assess the effect of mineralcorticoid blockade on top of standard treatment in patients with atrial fibrillation after sinus rhythm restoration on the recurrence of the arrhythmia, hospitalizations and on the changes in levels of Galectin-3 as a marker of fibrosis. Methods: We prospectively studied 101 consecutive patients (56 females) at mean age 68.2 ± 7 with atrial fibrillation and sinus rhythm restoration, who were randomized on treatment with spironolactone on top of standard treatment or “usual care”. They were followed up for recurrences, hospitalization and death. The effect of spironolactone on safety was evaluated. Results: Recurrences of AF were detected in 64% of non-spironolactone group vs 57% in spironolactone group (p = 0.44). Spironolactone reduced the hospitalizations for AF, but it was not significant (p = 0.14). A ...
Purpose: To assess the role of asymptomatic hyperuricemia for the presence and severity of corona... more Purpose: To assess the role of asymptomatic hyperuricemia for the presence and severity of coronary arterial calcium (CAC) in adults with different cardiovascular (CV) pathology and its association with conventional CV risk factors. Material/Methods: Adults (n=81) of both genders were divided into controls: with moderateto high risk without known CVD; AF-group: CVD-patients with paroxysmal or persistent atrial fibrillation in sinus rhythm, HF–group: heart failure subjects with preserved ejection fraction. A structured interview was performed at admittance for evaluation of the classical CVD risk factors. CAC score (CACS) was determined by multislice computed tomography. Routine laboratory parameters, including uric acid (UA), were extracted from medical documentation. Descriptive statistics, Mann-Whitney U-test, one-way ANOVA, chi-square test, Spearman’s correlation, and multiple linear regression analysis were applied. The predictive power of serum UA was evaluated using receiver o...